TUR syndrome
TUR (hypervolemic-hypotonic) syndrome is a life-threatening complication of transurethral prostatectomy (TUPE, TURP). This condition is particularly serious in elderly people and cardiac patients, who experience an overload of the body's circulation with all possible consequences.
Etiopathogenesis
This condition occurs during extensive or long-lasting resection (over 60 minutes), when the irrigation solution is resorbed through the open periprostatic venous plexuses, thereby diluting the extracellular fluid.
A similar complication can rarely occur even after percutaneous lithotripsy of a stone in the kidney.
Symptoms
- Unrest,
- confusion,
- shortness of breath
- nausea ,
- vomiting _
- tachycardia ,
- hypertension ,
- hyperbilirubinemia ,
- in the most severe cases, even anuria - from massive blockage of the glomeruli by fragments of disintegrated erythrocytes. Appears immediately after surgery.
Laboratory examination
This is dilutional hyponatremia.
Prevention
Prevention is the careful execution of TUR, consistent coagulation of large vessels and the use of low-pressure circulation of irrigation fluid.
Therapy
Administration of diuretics and hypertonic solution (10%) NaCl iv
Links
Related Articles
References
- HANUŠ T. A KOL.:,. Vzdělávací program urologie UK 1LF- elektronický program [online]. [cit. 2015-01-19]. <https://el.lf1.cuni.cz/admin/content/folder/list?filter-rows=100&filter-start%0&sco-id=744722&tab-id=9>.
- DVOŘÁČEK, Jan. Urologie praktického lékaře. 1. edition. Praha : ISV, 2000. 316 pp. pp. 65. ISBN 80-85866-52-8.
